| NPI | 1932241320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK ALLEN LEVISON Owner President 636-532-1646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 10818154) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |